NPI | 1619176203 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A94591) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 048439) |
2085R0202X Radiology, Diagnostic Radiology (Licence: NY 256173) | |
Enumeration Date | 2007-07-13 |
Last Update Date | 2011-10-25 |